Disorders of the Esophagus

Do you have heartburn? Discomfort when you eat? It’s time to find out how and why these uncomfortable symptoms may be affecting your health. When you feel discomfort in your esophagus, the long connector between your mouth and your stomach, you may have a disorder that needs treatment before it worsens.

At Mount Sinai, we have long been a center of excellence in the diagnosis and treatment of all types of disorders of the esophagus including:

• Gastroesophageal reflux (GERD): acid reflux that causes discomfort
• Eosinophilic esophagitis: an inflammation of the esophagus
• Barrett’s esophagus: a precancerous condition that requires routine monitoring

Gastroesophageal Reflux (GERD)

GERD occurs when the stomach acid flows back into your esophagus from your stomach. This acid irritates the lining of your esophagus, causing a burning sensation in your chest. You can also have chest pain, difficulty swallowing, and even regurgitating food.

If you smoke, are overweight, eat fatty or fried foods frequently, you are prone to developing GERD. Your doctor can give you tips on how to manage your reflux, but generally over-the-counter medications such as antacids or medicines that help block acid and repair the esophageal lining are used.

We can prescribe other medications when necessary, and in cases where medications don’t help, there are some surgical options for you.

Eosinophilic Esophagitis (EoE)

EoE is the build-up of white blood cells along your esophagus caused by a reaction to foods, allergens, or reflux. This build-up causes inflammation of the esophagus, which makes it difficult for you to swallow or pass food through to the stomach.

This is an immune disorder that we generally treat with dietary therapies, medications including a proton pump inhibitor, and endoscopic therapies such as dilation of the esophagus to reduce narrowing.

Barrett’s Esophagus

Barrett’s esophagus occurs following persistent GERD that causes the cells of the small intestine to replace cells of the esophagus. You may not realize that you have Barrett’s because you may not have symptoms other than those of usual reflux or heartburn of GERD.

It is important to have your esophagus checked for Barrett’s since the condition tends to lead to cancer. If you have Barrett’s esophagus, we will monitor you closely for any changes in the lining of your esophagus. We likely will recommend removing any suspicious areas or lesions that we find.

To diagnose Barrett’s esophagus, our doctors use the latest minimally invasive techniques. We use a number of techniques to look deep into the wall of the esophagus.

One technique is volumetric laser and microscopy in which a laser scans the esophageal wall looking for abnormalities using a wide area transepithelial (WATS) brush. This takes cell samples to determine if they are becoming cancerous.

We use the following techniques to diagnose and treat Barrett’s esophagus:

• Radio frequency ablation or microwave energy: heats up the abnormal cells which causes them to die off
• Cryotherapy therapy: freezes and destroys the abnormal cells with either a liquid nitrogen spray or a nitrous oxide balloon
• Endoscopic mucosal resection technique: enables us remove areas of concerning cells for a pathology lab examination

Mount Sinai offers individualized approaches for the diagnosis and treatment of Barrett’s esophagus, which means that you receive comprehensive and collaborative care with compassion and comfort.